The patient was found to have 4+urine sugar by physical examination 14 years ago and was treated with oral hypoglycemic drugs. Insulin was injected intramuscularly nine years ago. Two and a half years ago, it was foun...The patient was found to have 4+urine sugar by physical examination 14 years ago and was treated with oral hypoglycemic drugs. Insulin was injected intramuscularly nine years ago. Two and a half years ago, it was found that the color of the thumb, index and middle toe of the left foot became black. He went to a third-class hospital in Beijing and was diagnosed as “diabetes foot”. He was treated with “balloon dilation of lower limb blood vessels of diabetes foot”. Half a year ago, the third toe on the right side was broken and treated in the hospital again. “Popliteal artery stent implantation” was given for the diagnosis of “double kidney insufficiency, diabetes foot, left heart failure, combined heart valve disease”, “Hemofiltration therapy” and anti-inflammatory, amino acid supplementation, kidney function protection, anticoagulation, anemia correction and other treatments. Later, he went to our hospital and was diagnosed by the TCM diagnosis: category of consumptive disease, toe or finger gangrene (syndrome/pattern of qi and yin deficiency). Western medicine diagnosed: stage V of diabetes nephropathy, type II diabetes foot gangrene, combined with heart valve disease, hypoalbuminemia, double kidney cyst, moderate anemia, pleural effusion, hyperkalemia, pulmonary infection, and total heart failure. The patient was treated by the Qi-acupuncture therapy of TCM in combination with Chinese and Western medicine Medical treatment made the patient significantly better and discharged.展开更多
Objective:To observe the efficacy of Yiqi Huoxue Decoction in the treatment of patients with diabetic nephropathy(DN)stageⅢwith qi and yin deficiency and stasis and its effects on vascular endothelial growth factor(V...Objective:To observe the efficacy of Yiqi Huoxue Decoction in the treatment of patients with diabetic nephropathy(DN)stageⅢwith qi and yin deficiency and stasis and its effects on vascular endothelial growth factor(VEGF)and transforming growth factor-β(TGF-β1).Methods:Sixty patients with stage DN of Qi-yin deficiency and stasis type DN who were treated in the Endocrinology Department of the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from September 2018 to December 2019 were selected as the research subjects.The remainder method was used to divide them into 30 cases in the observation group and 30 cases in the control group.Patients in both groups were referred to the guidelines and expert consensus for general treatment of DN(hypogl-ycemic,antihypertensive,lipid-lowering,etc.).The control group was given pancreatic kallikrein enteric-coated tablets orally once,120U,3 times a day,and the observation group was given The traditional Chinese medicine Yiqi Huoxue Decoction was taken orally,one dose daily,twice a day in the morning and evening;the two groups intervened continuously for 8 weeks.Detect blood FPG,PBG,HbA1c,β2-MG,BUN,SCr,VEGF,TGF-β1,and urine mALB and UACR levels before and after treatment,and calculate eGFR before and after treatment in both groups;observe changes in TCM syndrome scores in the two groups,Compare its clinical efficacy.Results:After 8 weeks of treatment,the total clinical effective rate of patients in the observation group was 93.3%,which was significantly different from the control group of 76.6%(P<0.05);the TCM syndrome scores in the observation group were significantly lower than those before treatment and in the control group(P<0.05);The levels of FPG,HbA1c,PPG,mALB,β2-MG,UACR,VEGF,and TGF-β1 in the observation group were significantly lower than those in the control group,with significant differences(P<0.05).The levels of SCr and BUN in the observation group were significantly lower.Compared with before treatment,eGFR increased,but there was no signi-ficant difference(P>0.05).Conclusion:Yiqi Huoxue Decoction for the treatment of patients with DN typeⅢqi-yin deficiency and stasis type,not only helps to lower blood sugar levels,improve TCM syndromes,but also can reduce early renal damage,reduce urine albumin,and delay kidney function It may be further worsened and has better safety.The mechanism may be related to reducing the levels of VEGF and TGF-β1,thereby delaying the fibrosis of tubulointerstitial scar and inhibi-ting glomerular capillary sclerosis.展开更多
As a dreaded consequence of diabetes mellitus (DM),diabetic nephropathy (DN)accounts for about 40%of end-stage renal disease (ESRD). It is a universal cause of ESRD,and can be considered as an independent risk factor ...As a dreaded consequence of diabetes mellitus (DM),diabetic nephropathy (DN)accounts for about 40%of end-stage renal disease (ESRD). It is a universal cause of ESRD,and can be considered as an independent risk factor for cardiovascular disease. In recent years,TCM has show n its unique advantages in the treatment of DN. As one of the chronic diseases caused by living styles,DN has the higher requirements for nursing. Nevertheless,TCM nursing based on syndrome differentiation can provide the personalized guidance for the patients w ith DN according to different syndrome patterns and symptoms. Therefore,this article mainly explored the key points of common syndromes,TCM nursing methods and health guidance of DN in order to further develop the advantages of TCM,improve its efficacy and standardized its nursing behavior.展开更多
目的探讨水陆二仙丹联合抵挡汤加减方对早中期糖尿病肾病患者的临床疗效。方法83例患者随机分为对照组(42例)和观察组(41例),对照组给予厄贝沙坦片,观察组在对照组基础上加用水陆二仙丹联合抵挡汤加减方,疗程12周。检测临床疗效、中医...目的探讨水陆二仙丹联合抵挡汤加减方对早中期糖尿病肾病患者的临床疗效。方法83例患者随机分为对照组(42例)和观察组(41例),对照组给予厄贝沙坦片,观察组在对照组基础上加用水陆二仙丹联合抵挡汤加减方,疗程12周。检测临床疗效、中医证候评分、血糖指标(FBG、HbA1c)、血脂指标(TC、TG)、肾功能指标(BUN、Scr、24 h UTP、eGFR)、炎症因子(IL-1β、hs-CRP、IL-6、TNF-α、IL-18、TGF-β1)、免疫功能指标(淋巴细胞、中性粒细胞、CD8^(+)、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))、不良反应发生率变化。结果观察组总有效率高于对照组(P<0.05)。治疗后,观察组中医证候评分、血糖指标、血脂指标、BUN、Scr、24 h UTP、炎症因子、CD8^(+)降低(P<0.05),淋巴细胞、中性粒细胞减少(P<0.05),eGFR、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)升高(P<0.05),并比对照组更明显(HbA1c、TG、SCr、24 h UTP、淋巴细胞、中性粒细胞除外)(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论水陆二仙丹联合抵挡汤加减方可安全有效地改善早中期糖尿病肾病患者临床症状,其机制可能与降低炎症水平、改善机体免疫功能有关。展开更多
文摘The patient was found to have 4+urine sugar by physical examination 14 years ago and was treated with oral hypoglycemic drugs. Insulin was injected intramuscularly nine years ago. Two and a half years ago, it was found that the color of the thumb, index and middle toe of the left foot became black. He went to a third-class hospital in Beijing and was diagnosed as “diabetes foot”. He was treated with “balloon dilation of lower limb blood vessels of diabetes foot”. Half a year ago, the third toe on the right side was broken and treated in the hospital again. “Popliteal artery stent implantation” was given for the diagnosis of “double kidney insufficiency, diabetes foot, left heart failure, combined heart valve disease”, “Hemofiltration therapy” and anti-inflammatory, amino acid supplementation, kidney function protection, anticoagulation, anemia correction and other treatments. Later, he went to our hospital and was diagnosed by the TCM diagnosis: category of consumptive disease, toe or finger gangrene (syndrome/pattern of qi and yin deficiency). Western medicine diagnosed: stage V of diabetes nephropathy, type II diabetes foot gangrene, combined with heart valve disease, hypoalbuminemia, double kidney cyst, moderate anemia, pleural effusion, hyperkalemia, pulmonary infection, and total heart failure. The patient was treated by the Qi-acupuncture therapy of TCM in combination with Chinese and Western medicine Medical treatment made the patient significantly better and discharged.
基金Chinese Medicine Research Project of Jiangxi Provincial Health and Family Planning Commission(No.2018A004)
文摘Objective:To observe the efficacy of Yiqi Huoxue Decoction in the treatment of patients with diabetic nephropathy(DN)stageⅢwith qi and yin deficiency and stasis and its effects on vascular endothelial growth factor(VEGF)and transforming growth factor-β(TGF-β1).Methods:Sixty patients with stage DN of Qi-yin deficiency and stasis type DN who were treated in the Endocrinology Department of the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from September 2018 to December 2019 were selected as the research subjects.The remainder method was used to divide them into 30 cases in the observation group and 30 cases in the control group.Patients in both groups were referred to the guidelines and expert consensus for general treatment of DN(hypogl-ycemic,antihypertensive,lipid-lowering,etc.).The control group was given pancreatic kallikrein enteric-coated tablets orally once,120U,3 times a day,and the observation group was given The traditional Chinese medicine Yiqi Huoxue Decoction was taken orally,one dose daily,twice a day in the morning and evening;the two groups intervened continuously for 8 weeks.Detect blood FPG,PBG,HbA1c,β2-MG,BUN,SCr,VEGF,TGF-β1,and urine mALB and UACR levels before and after treatment,and calculate eGFR before and after treatment in both groups;observe changes in TCM syndrome scores in the two groups,Compare its clinical efficacy.Results:After 8 weeks of treatment,the total clinical effective rate of patients in the observation group was 93.3%,which was significantly different from the control group of 76.6%(P<0.05);the TCM syndrome scores in the observation group were significantly lower than those before treatment and in the control group(P<0.05);The levels of FPG,HbA1c,PPG,mALB,β2-MG,UACR,VEGF,and TGF-β1 in the observation group were significantly lower than those in the control group,with significant differences(P<0.05).The levels of SCr and BUN in the observation group were significantly lower.Compared with before treatment,eGFR increased,but there was no signi-ficant difference(P>0.05).Conclusion:Yiqi Huoxue Decoction for the treatment of patients with DN typeⅢqi-yin deficiency and stasis type,not only helps to lower blood sugar levels,improve TCM syndromes,but also can reduce early renal damage,reduce urine albumin,and delay kidney function It may be further worsened and has better safety.The mechanism may be related to reducing the levels of VEGF and TGF-β1,thereby delaying the fibrosis of tubulointerstitial scar and inhibi-ting glomerular capillary sclerosis.
文摘As a dreaded consequence of diabetes mellitus (DM),diabetic nephropathy (DN)accounts for about 40%of end-stage renal disease (ESRD). It is a universal cause of ESRD,and can be considered as an independent risk factor for cardiovascular disease. In recent years,TCM has show n its unique advantages in the treatment of DN. As one of the chronic diseases caused by living styles,DN has the higher requirements for nursing. Nevertheless,TCM nursing based on syndrome differentiation can provide the personalized guidance for the patients w ith DN according to different syndrome patterns and symptoms. Therefore,this article mainly explored the key points of common syndromes,TCM nursing methods and health guidance of DN in order to further develop the advantages of TCM,improve its efficacy and standardized its nursing behavior.
文摘目的探讨水陆二仙丹联合抵挡汤加减方对早中期糖尿病肾病患者的临床疗效。方法83例患者随机分为对照组(42例)和观察组(41例),对照组给予厄贝沙坦片,观察组在对照组基础上加用水陆二仙丹联合抵挡汤加减方,疗程12周。检测临床疗效、中医证候评分、血糖指标(FBG、HbA1c)、血脂指标(TC、TG)、肾功能指标(BUN、Scr、24 h UTP、eGFR)、炎症因子(IL-1β、hs-CRP、IL-6、TNF-α、IL-18、TGF-β1)、免疫功能指标(淋巴细胞、中性粒细胞、CD8^(+)、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))、不良反应发生率变化。结果观察组总有效率高于对照组(P<0.05)。治疗后,观察组中医证候评分、血糖指标、血脂指标、BUN、Scr、24 h UTP、炎症因子、CD8^(+)降低(P<0.05),淋巴细胞、中性粒细胞减少(P<0.05),eGFR、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)升高(P<0.05),并比对照组更明显(HbA1c、TG、SCr、24 h UTP、淋巴细胞、中性粒细胞除外)(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论水陆二仙丹联合抵挡汤加减方可安全有效地改善早中期糖尿病肾病患者临床症状,其机制可能与降低炎症水平、改善机体免疫功能有关。
